740542.pdfr I�
BUILDING DEPARTMENT Applicant Fill °NE NUMMBBETR 740542 I{
PERMIT APPLICATION InSido Heavy Lines JOD �rar_I�
ADDRESS
NAME (OR NAME OF BUSINESS)
PER. ISSIB E
LOT COVERAGE LOTUCOVEXAGE
X Mrf.I�jRO ADDREBB A�
/ PERTIItleIHLE HEIGHT PROPOSED HEIGHT C
/�9aa Sountiv/rw P/act
CITY TELEPHONE N -•UMBER ACTUAL LOT AREA TOTAL BLDG. AREA x
REQUIRED YARDS PROPOSED YARDS
N ME FRONT SIDE REAR FRONT BIDE REAR
WADDRESS LEGAL LOT VAKIANCE OR CONDITIONAL USE 1
yMy D VES 0 NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
i
CITY (TELEPHONE NUMBER
c STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
NAME
/� COMP. PLAN ST. R/W ............FT. ............ FT. 14
!/LiI/1 er REMARKS z1
9 ADDREBB
O
I, 2
CHECKED BY W �j
CF CITY (TELEPHONE NUMBER
V METER SIZE SERVICE 81ZE CLEARANCE CHECKED BY
STATE LICENSE NUMBER
CITY LICENSE NUMBER
i
I
—
Legal Description of Property (show Below
Attach Four
REMARKS
or Copies)
TYPE CONNECTION
VERIFIED BY
`
O
n
PERC. TEST
PERMIT NUMBER
�C
5
I
7
REMARKS
-7
t7
1
.�1
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
I 0 YES Q No
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
RESIDENTIAL
❑ OAS
❑ YES 0 NO
NEW
PLAN CHECKED IIY
THIS SITE IS LOCATED IN THE CITY
❑LINE
NON-RESIDENTIAL
EDMONDS. LOC AL SALES TAX
j
ADD
SIGNOF
SHOULD 8E CODED 31 04
RETAINING
DEMOLISH WALL
RE.IARK9
ALTER ❑ EXCAVATE ❑ FENCE
El ALTER
OP. FILL
L.......... .......... Ft.)
REPAIR PRE-1'OVE .{VIM
❑ (NBP, El
;
NUMBER Ol• STORIES NUMBER OF
t
1
DWELLING
I
UNITS
NATURE OF {YORK TO HE DONE
Valuation
Fee Receipt No.
•l.
Pl.n Check N. .....................
BUILDING
aPROPOSED USE
0
PLUMBING
aPLOT
PLAN (Indleal. Building setback., nbuttlas streets)
HEAT k GAS LINE
l
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
{
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I hnvo read this application; that the In -
O
i
lion given Is correct; and that I am the owner, or the duly author-
Ired .sent .f the owner. I doing to with Situ and erste taws rsgu-
Iatln6 conetrucllon; In dolog the
ATTENTION
APPLICATION APPROVAL
and wall
worir nuth.rize6 thereby, no peteon
will be employed In violation of the Labor Code of the Stale of Washington
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Insurance,
AUTHORIZES
ONLY TILE
signed by the Building Official or his Dep-
,�-,�------I
NOTE: Permit Limit One Year (Except DEMOLITIONS which
uty; and fees are and receipt is
i
shall be completed In ninety days; MOVED -IN BUILDINGS shalt be cam-
WORK NOTED
paid, ac-
knowledged in space
1
plcted In six months.)
provided.
SIGNATURE, (OWNER Olt AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
D1RF/. OR'S lONATU fl .'` r r,.
CITY OF
1 :('P, d,
ED11fONDS
D
NOTE: Applicant Subject to Plan Check Fee
775-2525
I
This Permit rovrr. wark to be done on Prl-t. property ONLY.
Any c—, n,etl.n nn tke Plblle domain (eurhe, eldewNNe, drlrewaye.
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